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Postoperative non-traumatic compartment syndrome (PNCS) in gynecologic surgery

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The postoperative non-traumatic compartment syndrome (PNCS) is a rare, but serious postoperative complication. Etiology, risk factors and clinical manifestation of PNCS are not well characterized since data in gynecologic and obstetric patients are limited.

Methods

We performed a retrospective monocentric study of patients who underwent surgery for gynecologic or obstetrics conditions and identified five cases of PNCS, which were analyzed and compared to a control cohort in regard of incidence, clinical presentation, risk factors and clinical outcome.

Results

Five cases of PNCS were identified among 19.432 patients treated between 2008 and 2019 with an incidence rate of 0.026%. The clinical examination was shown to be unreliable, lacking sensitivity in most clinical signs. Young age, obesity and long operation time were risk factors for the development of a PNCS. Fasciotomy for the treatment of a PNCS should not be delayed, since permanent function loss may occur early.

Conclusion

A low threshold of clinical suspicion might be prudent to identify PNCS following gynecologic surgery. In the presence of the described risk factors, any suspicion of a PNCS should be evaluated further and if necessary treated with fasciotomy urgently.

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Author information

Authors and Affiliations

  1. Department of Gynecology, University Hospital, Leipzig, Germany

    Massimiliano Lia, Shadi Younes, Bahriye Aktas & Marc Philipp Radosa

  2. Department of Gynecology, Saarland University Hospital Saarland, Homburg, Germany

    Julia Caroline Radosa

  3. Department of Anesthiology, Agaplesion Diakonie Hospital, Kassel, Germany

    Andreas Fiehn

  4. Department of Vascular Surgery, Agaplesion Diakonie Hospital, Kassel, Germany

    Thomas Buerger

  5. Department of Gynecology, St Georg Hospital, Eisenach, Germany

    Anke Mothes

Authors
  1. Massimiliano Lia
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  2. Julia Caroline Radosa
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  3. Shadi Younes
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  4. Andreas Fiehn
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  5. Thomas Buerger
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  6. Anke Mothes
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  7. Bahriye Aktas
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  8. Marc Philipp Radosa
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Contributions

ML, SY and MPR were responsible for the conception and design of the study, interpretation of data and drafting the manuscript. SY contributed substantially to the acquisition of the data. ML, SY and MPR performed statistical analysis of the data and revised the manuscript critically for intellectual content. AM and JCR contributed substantially to the analysis of the data. AF and TB were involved in designing the study with regards to anesthesiological and vascular surgical aspects and made substantial contributions in interpretation of data and editing of the manuscript. BA was involved in the critical revision of the manuscript. All authors reviewed the manuscript and contributed to the final submission.

Corresponding author

Correspondence to Marc Philipp Radosa.

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Conflict of interest

We declare that we have no conflict of interest.

Ethical approval

The study was conducted in concordance with the ethical standards of the institution.

Informed consent

Only retrospective data from patient records have been analyzed. No intervention was performed and all patients were treated according to the existing clinical guidelines. All patients gave their agreement to analyze and publish data anonymously before treatment.

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Lia, M., Radosa, J.C., Younes, S. et al. Postoperative non-traumatic compartment syndrome (PNCS) in gynecologic surgery. Arch Gynecol Obstet 301, 1013–1019 (2020). https://doi.org/10.1007/s00404-020-05480-y

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  • DOI: https://doi.org/10.1007/s00404-020-05480-y

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